Purpose: :
Severe Central Serous Chorioretinopathy (CSC) aftercardiac transplantation is a sight threatening manifestation.Its treatment is difficult as systemic corticosteroid therapycannot be avoided. Our purpose was to describe the angiographicand OCT features of CSC and its treatment with laser photocoagulation.

Methods: :
Observational case report of a 51 year–old patientcomplaining of important decrease of vision in both eyes within3 months of cardiac surgery. The patient had 5 allograft rejectionwithin 6 months and was treated with high doses of corticosteroidtherapy. A visual acuity evaluation, slit lamp biomicroscopy,fundus photography, fluorescein–, indocyanine green angiographyand OCT examinations were performed at each visit . Laser photocoagulations were performed in both eyes on the leakagepoints – beginning the treatment from the larger to thesmaller leakage point.

Results: :
The visual acuity (VA) was 20/200 at the right eyeand 20/400 at the left eye at first examination. In the righteye, an extensive serous pigment epithelium detachement (PED)with clear fluid next to the superior temporal arcade and somedistant leakage points in the juxtafoveal area were associatedto a central serous retinal detachment extending from the superiorarcade to the fovea. In the left eye, several PED–s inperipapillary position and at both arcades were associated toa central serous detachment and some exsudates in the fovea.Visual improvement was observed after 4 sessions of laser treatments(2 on both eyes). After 3 months of follow–up, VA was20/32 in the right and 20/100 on the left eye. Decrease of thesensory retinal detachement on the angiographic sequences andon OCT examination was probably involved in VA modification.

Conclusions: :
CSC in transplant population obviously unconfortable,demonstrates the deleterious effect of high doses of steroids.Progressive laser photocoagulation focused on leakage spotswhen indicated results in fair VA, as well as angiographic andOCT improvement in this patient.